The Care Quality Commission (CQC) released new quality statements and evidence categories under its single assessment framework, which will be officially launched ‘later in 2023’. Here we explore what the 'being safe' statement means.

The big news for 2023 is the change to the CQC Inspection process, which includes timeframes and criteria like ‘Quality Statements’ replacing the Key Lines of Enquiry (KLOEs).

CQC Quality Statements

As we’ve covered in a recent blog, the Care Quality Commission (CQC) released new quality statements and evidence categories under its single assessment framework, which will be officially launched ‘later in 2023’. The quality statements correspond to the existing five key questions:

• Are they safe?
• Are they effective?
• Are they caring?
• Are they responsive to people’s needs?
• Are they well-led?

Each statement is also followed by a list of the regulations (as per the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014) to which they apply.

The new quality statements are viewed as commitments that providers, commissioners and system leaders need to abide by in order to deliver person-centred care of the highest quality. This means that the CQC will expect these statements to be incorporated into everyday practice to ensure that the standard of care meets their requirements.

Furthermore, the term 'people' included in the statements not only refers to patients, but also their families, friends and carers, including those with protected characteristics under the Equality Act 2010 and those individuals likely to have a worse experience of care or experience care inequality.

Key question: Safe

There are eight quality statements under this key question:

1. Learning culture: A culture of safety that encourages open and honest communication, investigation of safety events, and identification of good practices in order to continually improve safety standards. (Regulations 12, 16, 17 and 20.)
2. Safe systems, pathways and transitions: works with people and their partners to create and maintain safe systems of care, with a focus on safety, monitoring and continuity of care, even when people move between services. (Regulations 9, 12 and 17.)
3. Safeguarding: Work with people and their partners to understand what safety means to them, and to create and maintain safe systems of care that protect people from bullying, harassment, abuse, discrimination, avoidable harm and neglect. (Related regulations 9, 11, 12, 13, 17 and 20.)
4. Involving people to manage risks: Understand and manage risks, so that care is safe, supportive, and helps people do the things that are important to them. (Regulations 9, 10, 11, and 12.)
5. Safe environments: Detect and control risks in the care environment, providing the necessary equipment, facilities and technology to ensure safe care is delivered. (Regulations 12, 15 and 17.)
6. Safe and effective staffing: ensures that there are adequate qualified and experienced personnel, with proper support and development, who work together to provide safe care tailored to individual needs. (Regulations 12, 18 and 19.)
7. Infection prevention and control: assess and manage infection risk, control spread and share concerns quickly. (Regulations 12, 15 and 17.)
8. Medicines optimisation: enable people to be involved in planning and changing medicines and treatments safely to meet their needs. (Regulations 9, 12 and 11.)

Evidence Categories

Although the quality statements vary under each key question, they all share the same evidence categories:

• People’s experience of health and care services
• Feedback from staff and leaders
• Feedback from partners.

Can You Evidence this?

If you look at past CQC inspection reports, they have identified issues around recruitment where Practices have not provided enough evidence – Regulation 19 requires that employers ensure that ‘fit and proper persons’ are employed, and that the Practice has made certain they are employing people of good character, checks on qualifications, references and competency are all done by the Practice.

Shortfalls in providing this was the lack of detail (and evidence) that Practices had received or recorded the following;

• Information on the current number of staff by role, their full-time equivalent (FTE)
• References requested as part of the recruitment process
• Proof of qualifications or training provided to them in the last three years.
• Evidence of training in areas such as safeguarding, fire safety, infection prevention and control, equality and diversity, medical emergencies and sepsis awareness, mental capacity, and chaperones.

Other suggested evidence to meet this could be the following;

• A record of serious untoward incidents/significant events from the last 12 months (including investigations, actions taken & how you implemented the learning from the event)
• Safeguarding, recruitment and fire safety policies and procedures
• Risk Assessments and action plans (e.g. Fire, health & safety, premises)
• Up to date Cleaning Schedule (including recent Infection Prevention & Control audit and action plans)

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